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Flipping the Classroom in Health Care Higher Education

A Systematic Review

Evans, Leda, DNP, RN; Vanden Bosch, Melodee L., PhD, RN; Harrington, Susan, PhD, RN; Schoofs, Nancy, PhD, RN; Coviak, Cynthia, PhD, RN

doi: 10.1097/NNE.0000000000000554
Feature Articles

Background The flipped classroom is an approach to teaching with independent and asynchronous study of content by students and active learning during scheduled class times.

Purpose The purpose of this review was to systematically examine research on the use of the flipped classroom approach in health professions education.

Methods Eleven electronic databases were searched for peer-reviewed literature from 2005 through September 2017. Inclusion criteria for studies addressed health professions students and quantitative outcomes (quizzes, examinations, course grades).

Results Of the 49 articles identified, 24 met the inclusion criteria. The majority of studies (n = 17) noted a significant improvement in at least 1 student academic outcome using the flipped classroom compared with the traditional lecture.

Conclusions This systematic review of the effects of the flipped classroom approach for the education of health professions students did not reveal compelling evidence for the effectiveness of the method in improving academic outcomes above that of traditional classroom approaches.

Author Affiliations: Nurse Practitioner (Dr Evans), Center for Endocrinology and Diabetes, Mercy Health Saint Mary's; and Assistant Professors (Drs Vanden Bosch and Harrington) and Professors (Drs Schoofs and Coviak), Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, Michigan.

The authors declare no conflicts of interest.

Correspondence Dr Vanden Bosch, 301 Michigan St NE, Grand Rapids, MI 49503 (

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Accepted for publication: April 16, 2018

Published ahead of print: July 13, 2018

Cite this article as: Evans L, Vanden Bosch ML, Harrington S, Schoofs N, Coviak C. Flipping the classroom in health care higher education: a systematic review. Nurse Educ. 2019;44(2):74–78. doi: 10.1097/NNE.0000000000000554

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